N.J. Admin. Code § 11:22-1.15

Current through Register Vol. 56, No. 21, November 4, 2024

Section 11:22-1.15 - Remediation/penalty

(a) Upon review of the reports required by 11:22-1.14, the Commissioner may require that the carrier , ODS, or the agent of a carrier or ODS, at its own expense:

1. Implement a plan of remedial action; and/or

2. Have the claims processing procedures of the carrier or its agent be monitored by a private auditing firm for a period to be determined by the Commissioner.

(b) The Commissioner may impose a civil penalty of not more than $ 10,000 upon the carrier , ODS, or the agent of a carrier or ODS, to be collected pursuant to the Penalty Enforcement Law, 2A:58-1 et seq., if, following the remediation measures in (a) above, the Commissioner determines that:

1. An unreasonably large or disproportionate number of eligible claims continue to be disputed, denied or not paid in accordance with the time frames in N.J.A.C. 11:22-1.5; or

2. A carrier , ODS, or the agent of a carrier or ODS has failed to pay interest as required pursuant to 11:22-1.7.

(c) In addition to any other penalties provided by law, the Commissioner may impose a civil penalty as set forth at 17B:30-55 against any person found in violation of this subchapter based upon their having engaged in a pattern or practice of conduct as determined by the Commissioner.

N.J. Admin. Code § 11:22-1.15

Reserved by 50 N.J.R. 571(a), effective 1/16/2018

Adopted by 50 N.J.R. 829(a), effective 2/5/2018